Severe haemorrhage following intrapleural streptokinase therapy for haemothorax after myocardial revascularisation with the left internal mammary artery

Administration of intrapleural streptokinase is a well-accepted therapy for the treatment of haemothorax following myocardial revascularisation with the inner mammary artery (IMA). The present report describes a patient who developed severe hypotension with an accompanying drop in haemoglobin concentration induced by the sixth consecutive instillation of intrapleural streptokinase. This case suggests that the standard streptokinase therapy of six to eight instillations might be too much for these patients.